Isoflurane: A Reliable and Widely Used Volatile Anesthetic Ensuring Safe and Stable Surgical Anesthesia Worldwide

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Introduction


Isoflurane is a widely used volatile anesthetic agent in general anesthesia. Introduced in the 1980s, it is known for its safety profile, cost-effectiveness, and stable hemodynamic properties. It is especially useful in longer surgeries requiring controlled depth of anesthesia.





Chemical and Physical Properties


Isoflurane is a halogenated ether with a moderate blood-gas partition coefficient of 1.4, allowing smooth induction and emergence. It is non-flammable, has a pungent odor, and is administered using a standard vaporizer.


Mechanism of Action


It acts by enhancing GABA-A receptor activity and inhibiting NMDA receptors, causing depression of the central nervous system. Isoflurane also activates potassium channels, contributing to its anesthetic effect and reduced neuronal excitability.


Clinical Advantages


Isoflurane maintains cardiovascular stability and reduces cerebral metabolic rate while preserving cerebral blood flow. It is less metabolized by the body, which minimizes organ toxicity. Its long track record makes it a preferred agent in many clinical settings.





Limitations and Side Effects


Its pungent smell can cause airway irritation, coughing, and breath-holding. Isoflurane may lead to dose-dependent hypotension due to vasodilation. It also contributes to environmental concerns, although less so than desflurane.


Conclusion


Isoflurane remains a trusted agent in modern anesthetic practice. Its balance between effectiveness, affordability, and safety makes it a mainstay in both developing and developed healthcare systems, particularly for stable, longer procedures.


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